When I started my medical teaching career in the late 80s, I was like any other typical South Indian medical teacher (including my teachers), who taught in the age old Indian style. As time went on, I could see the flaws in the medical curriculum, the examination system, especially the biased clinical examinations, the teachers’ attitude etc. Luckily my career was in private medical schools throughout. If I would have joined the Government institutes, my experience would have been the worst, due to politics! When I became the Associate professor after 6 years, I felt a restlessness growing inside me. My teaching style changed and my interest in revamping medical education was kindled. But as an ordinary Associate professor, working under someone, my options of reforms were very much restricted. However, thanks to the encouragement of my chairperson, I could possibly modify certain aspects of medical training within the Medical Council of India (MCI) framework. I read all the rules and regulations of the MCI and clearly understood the rotten medical education system. My institution underwent MCI inspection for post-graduate programs, and that experience was an eye-opener for me. I strongly felt that I can contribute much better than some old burnt out Govt. college professors who were acting as MCI inspectors in assessing the colleges in a unreasonable manner. But In India, if you need such post in MCI, you need some strong ‘pull and push’. In fact an opportunity came, but I firmly refused to get any post thru recommendation and influence. (By God’s grace, I followed that principle throughout my life).
In 2002, I got an opportunity to be a part of the main organizing group, of a new minority medical college project in Pondicherry. It was a turning point in my life, through which, I became an expert in MCI rules and MCI inspections and learnt the art of undertaking and succeeding in such inspections for new institutions. Hence I got opportunities to be involved in three new medical college projects till 2010. But my dream of creating a wonderful medical college run in a professional way, with innovative and relevant curriculum, good students and progressive teachers (and which could become a role-model institution), was never fulfilled. Probably in a country like India, it is too much to even think of such things! Anyone who starts a medical college in India has only one primary motive – to make money. The name, fame and all can be easily achieved later by aggressively hyped marketing. Many medical colleges have attained fame by these methods only. Once a hype is created, more students are attracted towards such colleges.
After retirement, I have enough time to think freely and have enlisted the requirements for starting a good medical college project in India. The list is not complete. Please read the following:
- Only trusts or organizations with at least 100,000 million (10,000 crores) Indian rupees as asset or turn over should enter this venture (even though even a ward councilor in politics has such huge money nowadays)! Politicians should not get involved in any such projects, to claim later the title of “Educationist” (A new fashion among the Indian politicians).
- The investor should have enough financial reserve, to support the project for the first ten years, without the need for bank loans.
- Those who start such project must be well aware of the medical need of the community, needs of medical teachers and the students.
- They should have enough land in an approachable area, whether it is an urban or rural set up. Even though MCI requires only 20 acres of land for starting a new medical college in India, my preference would be to have at least 60 acres for a nice campus for future development (as nobody is going to stop with just one MBBS program).
- The medical college should be predominantly rural health oriented, as our country needs more primary care physicians. Corporate hospital can be started separately somewhere else to feed the medical college hospital financially.
- Before starting a medical college, the investor must establish and run, a charity hospital at least three years prior, to get enough patients for students’ training. Both the college and hospital should not be started simultaneously (which is a standard practice till now).
- The hospital should adopt nearby villages (at least two) and cover their population under Govt. health insurance. 50% premium should be paid by the hospital and the remaining should be the contribution from the patient. The villagers can be provided with health care at a very nominal cost, within their insurance coverage. Primary health center should be started in the village as per MCI guidelines.
- The college hospital should have a proper architecture with adequate light and air ventilation. There is no need for grand elevation, but quality materials should be used which require least maintenance in the long run.
- Adequate transport facilities must be provided for patient care. 24 hours emergency service should be fully equipped with required gadgets and qualified professionals to tackle all emergencies.
- Once the hospital runs with good number of patients, the medical college project should start. The college building should be fully completed before the first batch of students join. Enough space must be provided, especially in lecture theaters, labs, library etc. for future developments. (But ideally, a medical college should have an intake of only, 100 students per year, to have an effective implementation of self-directed group learning)
- Adequate paramedical and supportive staff must be appointed when the project starts. Salary and perks should be good for all.
- The project should be well structured both physically and functionally with required manpower and patients, so that any surprise inspection by the MCI anytime can be faced and succeeded easily. Museums, library, labs etc. should be fully equipped.
- Strict humanism and ethics must be followed in patient-care.
- Teachers who are motivated for active work such as establishing departments, training the juniors and interested in innovative ideas should be recruited with the best salary and perks possible. A ’crèche’ to take care of the babies of the faculty and staff must be available within the campus
- College hostels must be well ventilated and convenient for students. Students should have room choices to choose from. Good mess and canteen facilities from a good industrial caterer must be provided. Adequate Jim and sports facilities are must.
- Innovative integrated curriculum must be provided. High speed internet broadband facilities and user friendly teaching aids are necessary.
- Each student and staff must be encouraged to plant a tree and take its responsibility till they are with the institution. Each student should be allotted a village family to study in depth, and he/she should be their ambassador for health care. They should have the opportunity to feel the life and struggle of the under served rural population. They should maintain a log of their activities.
- The institution should have indirect online feedback system for students to evaluate their faculty and the college facilities. Faculty should have the facility to evaluate the Dean and other administrators. Faculty should have periodic appraisals evaluating their performance for their future development and promotions.
- All appropriate committees must be formed and actively functional. Self-study report must be prepared by every department and strategic plans for the future must also be available. Grievances redressal committee and workplace harassment committee must be active and really functional.
Well, is your head reeling? I have given only the half. Now many of you may understand the deficiencies that are seen in our medical colleges. Is there any really good hearted group willing to start such a standard medical college with the points mentioned above? If there are any such, I am willing to put my heart and soul in that project for the first ten years. Any takers?